Glycative stress as a cause of macular degeneration

Authors: BEJARANO, ELOY - University Of Cardenal Herrera-Ceu; DOMENECH-BENDANA, ALICIA - University Of Cardenal Herrera-Ceu; AVILA-PORTILLO, NORMA - Consultant; ROWAN, SHELDON - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; EDIRISINGHE, SACHINI - Tufts University; TAYLOR, ALLEN - Tufts University

Submitted to: Progress in Retinal and Eye Research
Publication Type: Review Article
Publication Acceptance Date: 3/11/2024
Publication Date: 7/1/2024
Citation: Bejarano, E., Domenech-Bendana, A., Avila-Portillo, N., Rowan, S., Edirisinghe, S., Taylor, A. 2024. Glycative stress as a cause of macular degeneration. Progress in Retinal and Eye Research. https://doi.org/10.1016/j.preteyeres.2024.101260.
DOI: https://doi.org/10.1016/j.preteyeres.2024.101260

Interpretive Summary:

Technical Abstract: People are living longer and rates of age-related diseases such as age-related macular degeneration are accelerating, placing enormous burdens on patients and heath care systems. The quality of carbohydrate foods consumed by an individual impacts health. Specifically, consuming diets that favor slowly digested carbohydrates (low glycemic index) slow the rise in blood glucose following a meal and limits risk for major age-related diseases including age-related macular degeneration (AMD), cardiovascular disease, diabetes. The glycemic index is a kinetic measure of the rate at which glucose arrives in the blood stream after consuming various carbohydrates. Consuming higher glycemic index diets causes glycative stress and accumulation of advanced glycation end products. Such advanced glycation end products are cytotoxic by virtue of their forming abnormal proteins and protein aggregates, as well as inhibiting proteolytic and other protective pathways that might otherwise selectively recognize and remove toxic species. We developed in vitro and animal models of glycative stress, and we observed that consuming higher glycemic index diets perturbs metabolism and the microbiome, resulting in a shift to more lipid-rich metabolomic profiles. Interactions between aging, diet, eye phenotypes and physiology were observed. A large body of laboratory animal and human clinical epidemiologic data indicate that consuming lower glycemic index diets, or diets that create lower glycemia, is protective against features of early AMD in mice and AMD prevalence or AMD progression in humans. Drugs may be optimised to diminish the ravages of higher glycemia diets. Human trials are indicated to determine if AMD progression can be retarded using lower glycemic index diets. Here we summarized the current knowledge of the pathological role of glycative stress in retinal dysfunction and how dietary strategies might diminish retinal disease.